License Verification

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KENNETH VERNON SLACK

License Number: ME119973

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME119973
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
05/12/2014
Address of Record
5151 N 9th Ave
PENSACOLA, FL 32504
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 12/05/2020
HENDRIX, TIMOTHY WAYNE Supervisor Medical Doctor 65142 12/05/2020
O'BRIEN, PAUL BLAKE MD Supervising Prescribing Practitioner Medical Doctor 95514 09/23/2022

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Name Relationship Profession License Effective Date
WIDNER, LAUREN BROOKE Dispensing Physician Assistant Physician Assistant 9105907 8/10/2021

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/22/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.